News August 2012 Issue

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In The News: August 2012

PAP Injections Beat Acupuncture for Chronic Pain Relief

Scientists at the University of North Carolina have identified a new way to deliver pain relief through acupuncture. Several years ago, university researchers demonstrated how injecting prostatic acid phosphatase (PAP) into the spine eased chronic pain in rodents. The only problem was PAP’s delivery, which is invasive and must be performed in a clinical setting. They found that when an acupuncture needle is inserted into an acupuncture point and stimulated, nucleotides are released. These nucleotides are then converted into adenosine, which reduces the body’s sensitivity to pain. But for most acupuncture patients, relief lasts for only a few hours. Scientists, aware that PAP makes adenosine and lasts for days following spinal injection, wondered what would happen if PAP were injected into an acupuncture point. To find out, they injected PAP into the tissue area behind the knee. Surprisingly, they found that pain relief lasted 100 times longer than traditional acupuncture. By avoiding the spine, they also could increase the dose of PAP. The next step will be refining the protein for use in human trials.

Bone-Building Drugs May Help Artificial Joints Last Longer

Taking bisphosphonates before getting a hip or knee replacement may make a difference in how long your new joint lasts. A study conducted by the University of Southampton in the U.K. tracked 41,995 people (average age 70) who had a total knee or hip replacement, including 1,912 who had taken oral bisphosphonates, such as alendronate (Fosamax), risedronate (Actonel), or ibandronate (Boniva), for at least six months before their surgery. Five years later, 3 percent of those who had had a hip replacement and 4 percent of those with a knee replacement required revision surgery, an operation to replace the original implant (usually caused by loosening, which occurs when the bone supporting the joint has weakened). The revision rate for those taking bisphosphonates was about half that of the others, and their original implants lasted nearly twice as long.

New Test Predicts Arthritis at Earliest Stage

A research team from the University of Missouri’s Comparative Orthopaedic Laboratory has found a way to detect and predict arthritis before patients develop the disease. The test uses specific biomarkers that can accurately determine if a patient is developing osteoarthritis (OA) as well as predict the potential severity of the disease. The test can be run off a single drop of fluid from a patient’s joint. Researchers claim they can now study the levels of specific proteins that are known to be associated with OA, which may lead to better treatments in the future. Researchers developed the test by analyzing the joints of dogs that suffer from OA. Since canine joints operate similarly to human joints, the test is being adapted to human patients and is in the process of gaining FDA approval. Authors of the study claim that being able to tell patients when they are at high risk of developing OA will give doctors a strong motivational tool to convince patients to take early preventative measures.

Musculoskeletal Problems More Prevalent in Women

Osteoarthritis, osteoporosis, fractures, and spinal disorders all have one thing in common—they are musculoskeletal disorders and they are more prevalent in women. Ac-cording to researchers at Children’s National Medical Center in Washington, D.C., the differences are not solely due to hormone levels but to the inherent differences in biology between men and women at the cellular and molecular level. Responses to treatment—surgery, anesthesia, pain medication, rehabilitation—also differ with sex. Despite the fact that numerous studies have confirmed a higher prevalence of chronic musculoskeletal problems in women, little is known about why the gender differences exist. Researchers claim that more studies are needed to determine the cause, risk factors, and treatments. In orthopaedic practice in the future, they contend, sex differences in the physiology and development of disease will determine how each patient is treated.